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As a Pediatric Liver Transplant Surgeon, Kyle Soltys, MD, says he is fortunate to have a job that offers a unique degree of professional and personal satisfaction.
“From a professional standpoint, no surgery is more challenging and enjoyable than a complex liver transplant,” he says. “And in terms of personal satisfaction, I can’t think of another surgical specialty where I would have the opportunity to develop such long-term relationships with my patients. The children I transplanted when they were two years old are teenagers now, and some of the patients I transplanted as teenagers now have children of their own.”
Furthermore, as a member of the liver transplant surgical team at the Center for Rare Disease Therapy (CRDT) at UPMC Children's Hospital of Pittsburgh, Dr. Soltys says he has an exceptional working relationship with his nonsurgical colleagues.
“As a transplant surgeon, I don’t know what’s involved in medically managing a child who has, for example, maple syrup urine disease (MSUD),” he explains. “But at our CRDT multidisciplinary meetings, I may sit next to a colleague who understands that a child with MSUD runs the risk of having a stroke if she develops a head cold. This is a unique aspect of our multidisciplinary, collaborative approach here at Children’s.”
After graduating from Boston University School of Medicine and performing his residency in general surgery at University Hospital in Newark, New Jersey, Dr. Soltys completed an initial fellowship in transplantation at Mount Sinai Medical Center in New York before coming to Pittsburgh as a fellow at the Thomas E. Starzl Transplant Institute of UPMC in 2003. In 2005 he was appointed assistant professor of surgery and in 2014 associate professor of surgery at the University of Pittsburgh Medical School. He is an author of more than 70 published medical journal articles.
The CRDT’s multidisciplinary collaborative approach has fostered innovation in the use of liver transplants to improve the lives of children with metabolic diseases. Having pioneered liver transplantation for children with MSUD in the early 2000s, Children’s transplant group has since developed and refined new indications for transplantation such as urea cycle disorders and other rare conditions characterized by a missing enzyme that is concentrated in the liver.
“We have shown that for any metabolic disease where the missing enzyme is concentrated in the liver, a liver transplant will be curative because the donor liver provides the enzyme the patient lacks,” explains Dr. Soltys.
The CRDT’s multidisciplinary approach has also been instrumental in the development of novel approaches to liver transplantation such as “domino” transplants and living-donor transplants. In a domino transplant, a liver from a deceased donor is transplanted into a patient with MSUD; then, that patient's liver is transplanted into a third patient. In contrast to metabolic diseases in which the missing enzyme is concentrated in the liver, in MSUD the missing enzyme occurs throughout the body. For this reason, the liver from a patient with MSUD will work normally when transplanted into someone who does not have the enzyme deficiency that characterizes MSUD. To date Children’s transplant group has performed more than a dozen such domino transplants.
In a living-donor transplant, a small piece of an adult's liver is transplanted into a child. Uniquely among the body’s organs, the liver is able to regenerate. Thus, the transplanted piece of liver grows with the young transplant recipient into a fully functioning organ, while the adult donor’s liver also regrows. Living-donor transplants now make up close to half of all liver transplants performed at Children’s, a national leader in pediatric liver transplantation.
Dr. Soltys was also a member of the surgical team at Children’s that performed the first experimental transplant of liver cells (hepatocytes) into a patient with phenylketonuria. Children’s is the site of a clinical trial to determine whether hepatocyte transplantation may in the future offer an alternative to liver transplantation for patients with liver-based metabolic diseases.
In 2014, Dr. Soltys received the Tribute to Excellence Award from the American Liver Foundation, an award that was first won by Dr. Thomas Starzl himself. “I am tremendously honored to have followed in Dr. Starzl’s footsteps in receiving this award,” he commented at the time the award was announced.
Dr. Soltys has been a driving force behind a new partnership between Children’s Hospital of Pittsburgh and the University of Virginia Children’s Hospital in Charlottesville to expand access to pediatric liver transplant services to patients in the state of Virginia. He was a key member of the transplant team that performed the first transplant under this partnership in February 2016 – a 13-year-old girl from Norfolk, Virginia, who suffered from two genetic conditions that caused her liver and kidneys to fail, received a dual liver and kidney transplant.
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